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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT01212770




Registration number
NCT01212770
Ethics application status
Date submitted
29/09/2010
Date registered
1/10/2010
Date last updated
6/05/2020

Titles & IDs
Public title
PALACE 3: Efficacy and Safety Study of Apremilast to Treat Active Psoriatic Arthritis
Scientific title
A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Efficacy and Safety Study of Two Doses of Apremilast (CC-10004) in Subjects With Active Psoriatic Arthritis and a Qualifying Psoriasis Lesion
Secondary ID [1] 0 0
CC-10004-PSA-004
Universal Trial Number (UTN)
Trial acronym
PALACE 3
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Psoriatic Arthritis 0 0
Condition category
Condition code
Musculoskeletal 0 0 0 0
Osteoarthritis
Inflammatory and Immune System 0 0 0 0
Rheumatoid arthritis
Inflammatory and Immune System 0 0 0 0
Other inflammatory or immune system disorders
Musculoskeletal 0 0 0 0
Other muscular and skeletal disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Apremilast 20mg
Treatment: Drugs - Apremilast 30mg

Experimental: Apremilast 20 mg - 20 mg Apremilast tablets administered twice daily for 24 weeks during the placebo-controlled phase followed by 20 mg Apremilast tablets administered twice daily for up to 4.5 years in the active treatment / long-term safety phase

Experimental: Apremilast 30 mg - 30 mg Apremilast tablets administered twice a day for 24 weeks during the placebo-controlled phase followed by 30 mg Apremilast tablets administered twice a day for up to 4.5 years in the active treatment / long-term safety phase orally twice daily

Placebo comparator: Placebo + 20 mg Apremilast - Placebo + 20 mg Apremilast tablets administered twice daily for 24 weeks during the placebo-controlled phase followed by 20 mg Apremilast tablets administered twice daily for up to 4.5 years in the active treatment / long-term safety phase. Subjects who do not have at least 20% improvement in their swollen and tender joint counts at Week 16 will escape to 20 mg Apremilast twice daily at Week 16

Placebo comparator: Placebo + 30 mg Apremilast - Placebo + 30 mg Apremilast tablets administered twice daily for 24 weeks during the placebo-controlled phase followed by 30 mg Apremilast tablets administered twice daily for up to 4.5 years in the active treatment / long-term safety phase. Subjects who do not have at least 20% improvement in their swollen and tender joint counts at Week 16 will escape to 30 mg Apremilast twice daily at Week 16.


Treatment: Drugs: Apremilast 20mg
Apremilast 20 mg twice daily, orally

Treatment: Drugs: Apremilast 30mg
Apremilast 30 mg twice daily, orally
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 16
Timepoint [1] 0 0
Baseline and Week 16
Secondary outcome [1] 0 0
Change From Baseline in Health Assessment Questionnaire- Disability Index (HAQ-DI) at Week 16
Timepoint [1] 0 0
Baseline and Week 16
Secondary outcome [2] 0 0
Percentage of Participants With an ACR 20 Response at Week 24
Timepoint [2] 0 0
Baseline and Week 24
Secondary outcome [3] 0 0
Change From Baseline in Health Assessment Questionnaire- Disability Index (HAQ-DI) at Week 24
Timepoint [3] 0 0
Baseline and Week 24
Secondary outcome [4] 0 0
Change From Baseline in 36-item Short Form Health Survey (SF-36) Physical Functioning Domain at Week 16
Timepoint [4] 0 0
Baseline and Week 16
Secondary outcome [5] 0 0
Percentage of Participants With a Modified Psoriatic Arthritis Response Criteria (PsARC) Response at Week 16
Timepoint [5] 0 0
Baseline and Week 16
Secondary outcome [6] 0 0
Percentage of Participants Achieving a = 75% Improvement in Psoriasis Area and Severity Index Score (PASI75) at Week 16
Timepoint [6] 0 0
Baseline and Week 16
Secondary outcome [7] 0 0
Change From Baseline in Patient's Assessment of Pain at Week 16
Timepoint [7] 0 0
Baseline and Week 16
Secondary outcome [8] 0 0
Change From Baseline in Maastricht Ankylosing Spondylitis Entheses Score (MASES) at Week 16
Timepoint [8] 0 0
Baseline and Week 16
Secondary outcome [9] 0 0
Change From Baseline in Dactylitis Severity Score at Week 16
Timepoint [9] 0 0
Baseline and Week 16
Secondary outcome [10] 0 0
Change From Baseline in Clinical Disease Activity Index (CDAI) at Week 16
Timepoint [10] 0 0
Baseline and Week 16
Secondary outcome [11] 0 0
Change From Baseline in the Disease Activity Score (DAS28) at Week 16
Timepoint [11] 0 0
Baseline and Week 16
Secondary outcome [12] 0 0
Change From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 16
Timepoint [12] 0 0
Baseline and Week 16
Secondary outcome [13] 0 0
Change From Baseline in 36-item Short Form Health Survey (SF-36) Physical Functioning Domain at Week 24
Timepoint [13] 0 0
Baseline and Week 24
Secondary outcome [14] 0 0
Percentage of Participants With a Modified Psoriatic Arthritis Response Criteria (PsARC) Response at Week 24
Timepoint [14] 0 0
Baseline and Week 24
Secondary outcome [15] 0 0
Percentage of Participants Achieving a = 75% Improvement in Psoriasis Area and Severity Index Score (PASI75) at Week 24
Timepoint [15] 0 0
Baseline and Week 24
Secondary outcome [16] 0 0
Change From Baseline in Patient's Assessment of Pain at Week 24
Timepoint [16] 0 0
Baseline and week 24
Secondary outcome [17] 0 0
Change From Baseline in Maastricht Ankylosing Spondylitis Entheses Score (MASES) at Week 24
Timepoint [17] 0 0
Baseline and week 24
Secondary outcome [18] 0 0
Change From Baseline in Dactylitis Severity Score at Week 24
Timepoint [18] 0 0
Baseline and Week 24
Secondary outcome [19] 0 0
Change From Baseline in Clinical Disease Activity Index (CDAI) at Week 24
Timepoint [19] 0 0
Baseline and Week 24
Secondary outcome [20] 0 0
Change From Baseline in the Disease Activity Score (DAS28) at Week 24
Timepoint [20] 0 0
Baseline and Week 24
Secondary outcome [21] 0 0
Change From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 24
Timepoint [21] 0 0
Baseline and Week 24
Secondary outcome [22] 0 0
Percentage of Participants With MASES Improvement = 20% at Week 16
Timepoint [22] 0 0
Baseline and Week 16
Secondary outcome [23] 0 0
Percentage of Participants With Dactylitis Improvement = 1 Point at Week 16
Timepoint [23] 0 0
Baseline and Week 16
Secondary outcome [24] 0 0
Percentage of Participants With Good or Moderate European League Against Rheumatism (EULAR) Response at Week 16
Timepoint [24] 0 0
Baseline and Week 16
Secondary outcome [25] 0 0
Percentage of Participants With MASES Improvement = 20% at Week 24
Timepoint [25] 0 0
Baseline and Week 24
Secondary outcome [26] 0 0
Percentage of Participants With Dactylitis Improvement = 1 Point at Week 24
Timepoint [26] 0 0
Baseline and Week 24
Secondary outcome [27] 0 0
Percentage of Participants With Good or Moderate EULAR Response at Week 24
Timepoint [27] 0 0
Baseline and Week 24
Secondary outcome [28] 0 0
Percentage of Participants With a ACR 50 Response at Week 16
Timepoint [28] 0 0
Baseline and Week 16
Secondary outcome [29] 0 0
Percentage of Participants With an ACR 70 Response at Week 16
Timepoint [29] 0 0
Baseline and Week 16
Secondary outcome [30] 0 0
Percentage of Participants With an ACR 50 Response at Week 24
Timepoint [30] 0 0
Baseline and Week 24
Secondary outcome [31] 0 0
Percentage of Participants With a ACR 70 Response at Week 24
Timepoint [31] 0 0
Baseline and Week 24
Secondary outcome [32] 0 0
Percentage of Participants Achieving a MASES Score of Zero at Week 16
Timepoint [32] 0 0
Week 16
Secondary outcome [33] 0 0
Percentage of Participants Achieving a Dactylitis Score of Zero at Week 16
Timepoint [33] 0 0
Week 16
Secondary outcome [34] 0 0
Percentage of Participants Achieving a MASES Score of Zero at Week 24
Timepoint [34] 0 0
Week 24
Secondary outcome [35] 0 0
Percentage of Participants Achieving a Dactylitis Score of Zero at Week 24
Timepoint [35] 0 0
Week 24
Secondary outcome [36] 0 0
Percentage of Participants With an ACR 20 Response at Week 52
Timepoint [36] 0 0
Baseline and Week 52
Secondary outcome [37] 0 0
Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52
Timepoint [37] 0 0
Baseline and Week 52
Secondary outcome [38] 0 0
Change From Baseline in the SF-36 Physical Functioning Scale Score at Week 52
Timepoint [38] 0 0
Baseline and Week 52
Secondary outcome [39] 0 0
Percentage of Participants With a Modified PsARC Response at Week 52
Timepoint [39] 0 0
Baseline and Week 52
Secondary outcome [40] 0 0
Percentage of Participants Achieving a = 75% Improvement in Psoriasis Area and Severity Index Score (PASI75) at Week 52
Timepoint [40] 0 0
Baseline and Week 52
Secondary outcome [41] 0 0
Change From Baseline in the Patient Assessment of Pain at Week 52
Timepoint [41] 0 0
Baseline and Week 52
Secondary outcome [42] 0 0
Change From Baseline in Maastricht Ankylosing Spondylitis Entheses Score (MASES) at Week 52
Timepoint [42] 0 0
Baseline and Week 52
Secondary outcome [43] 0 0
Change From Baseline in the Dactylitis Severity Score at Week 52
Timepoint [43] 0 0
Baseline and Week 52
Secondary outcome [44] 0 0
Change From Baseline in the CDAI Score at Week 52
Timepoint [44] 0 0
Baseline and Week 52
Secondary outcome [45] 0 0
Change From Baseline in the DAS28 at Week 52
Timepoint [45] 0 0
Baseline and Week 52
Secondary outcome [46] 0 0
Change From Baseline in the FACIT-Fatigue Scale Score at Week 52
Timepoint [46] 0 0
Baseline and Week 52
Secondary outcome [47] 0 0
Percentage of Participants With MASES Improvement = 20% at Week 52
Timepoint [47] 0 0
Baseline and Week 52
Secondary outcome [48] 0 0
Percentage of Participants With Dactylitis Improvement = 1 Point at Week 52
Timepoint [48] 0 0
Baseline and Week 52
Secondary outcome [49] 0 0
Percentage of Participants Achieving Good or Moderate EULAR Response at Week 52
Timepoint [49] 0 0
Baseline and Week 52
Secondary outcome [50] 0 0
Percentage of Participants With an ACR 50 Response at Week 52
Timepoint [50] 0 0
Baseline and Week 52
Secondary outcome [51] 0 0
Percentage of Participants With an ACR 70 Response at Week 52
Timepoint [51] 0 0
Baseline and Week 52
Secondary outcome [52] 0 0
Percentage of Participants Achieving a MASES Score of Zero at Week 52
Timepoint [52] 0 0
Week 52
Secondary outcome [53] 0 0
Percentage of Participants Achieving a Dactylitis Score of Zero at Week 52
Timepoint [53] 0 0
Week 52
Secondary outcome [54] 0 0
Number of Participants With Treatment Emergent Adverse Events (TEAEs) During the Placebo-Controlled Phase
Timepoint [54] 0 0
Week 0 to Week 16 for placebo participants who entered EE at Week 16 and up to Week 24 for all other participants (placebo participants who remained on placebo through week 24 and participants randomized to the APR 20 mg BID or APR 30 mg BID)
Secondary outcome [55] 0 0
Number of Participants With Treatment Emergent Adverse Events During the Apremilast Exposure Period
Timepoint [55] 0 0
Week 0 to Week 260; median duration of exposure to apremilast 20 mg BID was 121.71 weeks and 232.50 weeks for apremilast 30 mg BID

Eligibility
Key inclusion criteria
* Males or females, aged = 18 years at time of consent.
* Have a diagnosis of Psoriatic Arthritis (PsA, by any criteria) of = 6 months duration.
* Meet the Classification Criteria for Psoriatic Arthritis (CASPAR) criteria for PsA at time of screening.
* Must have been inadequately treated by disease-modifying antirheumatic drugs (DMARDs)
* May not have axial involvement alone
* Concurrent Tx allowed with methotrexate, leflunomide, or sulfasalazine
* Have = 3 swollen AND = 3 tender joints.
* Males & Females must use contraception
* Stable dose of NSAIDs, narcotics and low dose oral corticosteroids allowed.
* Have at least one =2 cm psoriasis lesion
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
* Pregnant or breast feeding.
* History of allergy to any component of the investigational product Hepatitis B surface antigen and/or Hepatitis C antibody positive at screening.
* Therapeutic failure on > 3 agents for PsA or > 1 biologic tumor necrosis factor (TNF) blocker

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
30/09/2010
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
9/02/2017
Sample size
Target
Accrual to date
Final
505
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Royal Prince Alfred Hospital - Camperdown
Recruitment hospital [2] 0 0
Skin Cancer Foundation - Carlton
Recruitment hospital [3] 0 0
Coff's Clinical Trials - Coffs Harbour
Recruitment hospital [4] 0 0
Heidelberg Repatriation Hospital - Heidelberg
Recruitment hospital [5] 0 0
Menzies Centre for Population Health Research - Hobart
Recruitment hospital [6] 0 0
Optimus Clinical Research Pty. Ltd - Kogarah
Recruitment hospital [7] 0 0
Coastal Joint Care - Maroochydore
Recruitment hospital [8] 0 0
The Queen Elizabeth Hospital - Woodville
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
3053 - Carlton
Recruitment postcode(s) [3] 0 0
2450 - Coffs Harbour
Recruitment postcode(s) [4] 0 0
3081 - Heidelberg
Recruitment postcode(s) [5] 0 0
7000 - Hobart
Recruitment postcode(s) [6] 0 0
2217 - Kogarah
Recruitment postcode(s) [7] 0 0
4558 - Maroochydore
Recruitment postcode(s) [8] 0 0
5011 - Woodville
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Alabama
Country [2] 0 0
United States of America
State/province [2] 0 0
Arizona
Country [3] 0 0
United States of America
State/province [3] 0 0
California
Country [4] 0 0
United States of America
State/province [4] 0 0
Connecticut
Country [5] 0 0
United States of America
State/province [5] 0 0
Florida
Country [6] 0 0
United States of America
State/province [6] 0 0
Illinois
Country [7] 0 0
United States of America
State/province [7] 0 0
Indiana
Country [8] 0 0
United States of America
State/province [8] 0 0
Kentucky
Country [9] 0 0
United States of America
State/province [9] 0 0
Massachusetts
Country [10] 0 0
United States of America
State/province [10] 0 0
North Carolina
Country [11] 0 0
United States of America
State/province [11] 0 0
Ohio
Country [12] 0 0
United States of America
State/province [12] 0 0
Tennessee
Country [13] 0 0
United States of America
State/province [13] 0 0
Texas
Country [14] 0 0
Canada
State/province [14] 0 0
British Columbia
Country [15] 0 0
Canada
State/province [15] 0 0
Manitoba
Country [16] 0 0
Canada
State/province [16] 0 0
Newfoundland and Labrador
Country [17] 0 0
Canada
State/province [17] 0 0
Ontario
Country [18] 0 0
Finland
State/province [18] 0 0
Helsinki
Country [19] 0 0
Finland
State/province [19] 0 0
Pori
Country [20] 0 0
France
State/province [20] 0 0
Corbeil Essonnes
Country [21] 0 0
France
State/province [21] 0 0
Nantes
Country [22] 0 0
France
State/province [22] 0 0
Nice
Country [23] 0 0
France
State/province [23] 0 0
Toulouse
Country [24] 0 0
Germany
State/province [24] 0 0
Berlin
Country [25] 0 0
Germany
State/province [25] 0 0
Jena
Country [26] 0 0
Germany
State/province [26] 0 0
Mainz
Country [27] 0 0
Italy
State/province [27] 0 0
Bologna
Country [28] 0 0
Italy
State/province [28] 0 0
Roma
Country [29] 0 0
Korea, Republic of
State/province [29] 0 0
Anyang, Kyunggi
Country [30] 0 0
Korea, Republic of
State/province [30] 0 0
DaeJeon
Country [31] 0 0
Korea, Republic of
State/province [31] 0 0
Incheon
Country [32] 0 0
Korea, Republic of
State/province [32] 0 0
Seoul
Country [33] 0 0
Korea, Republic of
State/province [33] 0 0
Suwon
Country [34] 0 0
Lithuania
State/province [34] 0 0
Kaunas
Country [35] 0 0
Lithuania
State/province [35] 0 0
Klaipeda
Country [36] 0 0
Lithuania
State/province [36] 0 0
Panevezys
Country [37] 0 0
Lithuania
State/province [37] 0 0
Siauliai
Country [38] 0 0
Poland
State/province [38] 0 0
Bialystok
Country [39] 0 0
Poland
State/province [39] 0 0
Bytom
Country [40] 0 0
Poland
State/province [40] 0 0
Kraków
Country [41] 0 0
Poland
State/province [41] 0 0
Poznan
Country [42] 0 0
Poland
State/province [42] 0 0
Warszawa
Country [43] 0 0
Romania
State/province [43] 0 0
Baia Mare
Country [44] 0 0
Romania
State/province [44] 0 0
Bucharest
Country [45] 0 0
Romania
State/province [45] 0 0
Cluj-Napoca
Country [46] 0 0
Romania
State/province [46] 0 0
Galati
Country [47] 0 0
Romania
State/province [47] 0 0
Iasi
Country [48] 0 0
Russian Federation
State/province [48] 0 0
Ekaterinburg
Country [49] 0 0
Russian Federation
State/province [49] 0 0
Kezch
Country [50] 0 0
Russian Federation
State/province [50] 0 0
Novosibirsk
Country [51] 0 0
Russian Federation
State/province [51] 0 0
Penza
Country [52] 0 0
Russian Federation
State/province [52] 0 0
St. Petersburg
Country [53] 0 0
Slovakia
State/province [53] 0 0
Piestany
Country [54] 0 0
Slovakia
State/province [54] 0 0
Poprad,Spisska Sobota
Country [55] 0 0
Slovakia
State/province [55] 0 0
Rimavska Sobota
Country [56] 0 0
Spain
State/province [56] 0 0
A Coruña
Country [57] 0 0
Spain
State/province [57] 0 0
Bilbao
Country [58] 0 0
Spain
State/province [58] 0 0
Córdoba
Country [59] 0 0
Spain
State/province [59] 0 0
Oviedo
Country [60] 0 0
Spain
State/province [60] 0 0
San Sebastian de los Reyes
Country [61] 0 0
Switzerland
State/province [61] 0 0
Fribourg
Country [62] 0 0
Switzerland
State/province [62] 0 0
Lausanne
Country [63] 0 0
Switzerland
State/province [63] 0 0
St. Gallen
Country [64] 0 0
United Kingdom
State/province [64] 0 0
Burslem
Country [65] 0 0
United Kingdom
State/province [65] 0 0
Southampton

Funding & Sponsors
Primary sponsor type
Commercial sector/industry
Name
Amgen
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to determine whether apremilast is safe and effective in the treatment of patients with psoriatic arthritis and a qualifying psoriasis lesion.

Apremilast is proposed to improve signs and symptoms of psoriatic arthritis (tender and swollen joints, pain, physical function) in treated patients.
Trial website
https://clinicaltrials.gov/study/NCT01212770
Trial related presentations / publications
Edwards CJ, Blanco FJ, Crowley J, Birbara CA, Jaworski J, Aelion J, Stevens RM, Vessey A, Zhan X, Bird P. Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with psoriatic arthritis and current skin involvement: a phase III, randomised, controlled trial (PALACE 3). Ann Rheum Dis. 2016 Jun;75(6):1065-73. doi: 10.1136/annrheumdis-2015-207963. Epub 2016 Jan 20.
Mease PJ, Gladman DD, Kavanaugh A, McGonagle D, Nash P, Guerette B, Nakasato P, Brunori M, Teng L, McInnes IB. Articular and Extra-Articular Benefits in ACR20 Non-responders at Week 104 Treated With Apremilast: Pooled Analysis of Three Randomized Controlled Trials. Rheumatol Ther. 2021 Dec;8(4):1677-1691. doi: 10.1007/s40744-021-00369-x. Epub 2021 Sep 18.
Mease PJ, Gladman DD, Ogdie A, Coates LC, Behrens F, Kavanaugh A, McInnes I, Queiro R, Guerette B, Brunori M, Teng L, Smolen JS. Treatment-to-Target With Apremilast in Psoriatic Arthritis: The Probability of Achieving Targets and Comprehensive Control of Disease Manifestations. Arthritis Care Res (Hoboken). 2020 Jun;72(6):814-821. doi: 10.1002/acr.24134. Epub 2020 May 8.
Kavanaugh A, Gladman DD, Edwards CJ, Schett G, Guerette B, Delev N, Teng L, Paris M, Mease PJ. Long-term experience with apremilast in patients with psoriatic arthritis: 5-year results from a PALACE 1-3 pooled analysis. Arthritis Res Ther. 2019 May 10;21(1):118. doi: 10.1186/s13075-019-1901-3.
Gladman DD, Kavanaugh A, Gomez-Reino JJ, Wollenhaupt J, Cutolo M, Schett G, Lespessailles E, Guerette B, Delev N, Teng L, Edwards CJ, Birbara CA, Mease PJ. Therapeutic benefit of apremilast on enthesitis and dactylitis in patients with psoriatic arthritis: a pooled analysis of the PALACE 1-3 studies. RMD Open. 2018 Jun 27;4(1):e000669. doi: 10.1136/rmdopen-2018-000669. eCollection 2018.
Public notes

Contacts
Principal investigator
Name 0 0
MD
Address 0 0
Amgen
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/study/NCT01212770